Wednesday, December 19, 2007

My aunt Sylvia died this morning. She told her (grown) kids to go to school, asked for a drink of water, and took her last breath. She had end-stage pancreatic cancer and multiple myeloma, and she was at home, in a hospital bed in her living room.

We lived our lives at a great distance. Sylvia lived in Texas (San Antonio, Houston, Kerrville), ran a balloon delivery business, married a few men (not at the same time), and loved fiercely. She was the strongest and most indomitable person I ever knew. The way she lived with cancer taught me how to do it: You live. Just keep living. Keep doing things you want to do. If your bones are brittle, go to a water park and ride all the slides, and then take meds and sleep all the next day. If people you love are there, spend every ounce of your energy laughing with them, and then take meds and sleep all the next day. Don't be "sick" with cancer. It's an annoyance. It thinks it's in charge, so let it think so, but quietly go about your own business and don't let it stop you.

Until it's too strong. And then, recognize that you're tired, and lie back and marvel at the fresh, clean taste of cold water, and listen to songs that have always moved you, and wake up a few times a day to smile at the faces of the loving ones who surround you. Go home, and have your dog lie on the bed with you, and open the blinds each day to watch your own neighborhood and your own yard. Sleep, while your heart keeps beating and beating, while your nails turn dark and then pink again, while your breathing gets ragged and then smooth again.

And then, one morning, speak softly to your children, and just...Stop.

Thursday, November 29, 2007

From today's CNN, an article on a research study that says working nights is a big risk factor for breast (and prostate) cancer. Yikes. My typical schedule is to work at my computer until 1am (on an early night) to 4am (on a late night), and then get up around 11. In the winter, I am definitely restricting my exposure to sunlight--on weekends I might sleep in until noon or later.

The article seems quite specific to nighttime work, but the principles identified should apply to me, even if I'm not in a workplace per se. I'll be checking out the original study and will let y'all know!

Sunday, November 11, 2007

Something about the change in seasons has me really thinking about how this year feels different from last.

I have hair, for one thing. This past weekend, many of my friends and colleagues were at the Wharton Junior Faculty conference, for Organizational Behavior professors. Last year, I spoke at that conference, wearing a wig because my glorified stubble was still just a little not-ready-for-prime-time. I really thought I'd have hair down to my shoulders by now--I know my hair's always been quite shy and retiring, but I thought it could at least grow... In any case, it took a long time, but I've graduated from baby clips and air-drying to toddler clips and blow-drying, and sometimes it actually gets in my eyes...amazing.

Then there's energy. These days, I can pretty easily go out for 5+ hours of beach volleyball, if the sunlight is cooperating. I've never been a runner, but today I ran with Kibble for about a mile in addition to our mile-plus walk, and felt great.

During chemo, energy was a weird, weird thing. Ordinarily, I think of energy as depleting somewhat the way a bathtub drains--slowly, steadily. But during chemo, it was as if the bottom of the bathtub suddenly vanished, and all that water just gushed down at once. One minute, fine. The next minute--empty. A while after all my treatment ended, we went out for a walk and, about 5 minutes into it, I had to sit on someone's wall until I could summon the strength just to get back home. That was the last time the "emptying" happened, but still for a long time I got tired quickly, had fewer resources, just couldn't push through at those times when I needed to.

As mentioned in a recent post, surgery gave me a numb armpit and arm; taxol gave me burning feet. Adriamycin gave me awful nausea, and chemo in general gave me heartburn, which lasted until the first day of my diet, whereupon it magically disappeared. I had fuzzy thinking and lost words, lost periods, altered sense of smell and taste. I even had a hot flash or two.

Today, every single bit of that is gone. My hormonal system is still reeling, I think, but the rest of me is pretty much back. Thanks to diet and exercise, I'm in better shape than before.

Obviously, no one can be sure that cancer won't come back. But for now, I really want to report to anyone still going through treatment (or just finished) that you do get your life back. Going through the whole breast cancer Experience really sucks and is scary. But from this point of view, looking back, that one sucky year has not taken over my life. I hope it helps someone out there to know that. Just hang in there!!

Again, a flurry of recent news stories. I was particularly interested in this piece on Slate.com, which tackles the issue of "socialized medicine" and effective cancer treatment. It's interesting that this coincides with the American Cancer Society's activism drive to increase access to cancer treatment. The ACS wants more people to be treated, and to eliminate insurance problems as an obstacle to treatment. One obvious way to do that is to extend healthcare coverage through universal coverage options. Of course, that stirs panic among both right-wing and small-government types, and among ordinary people who might rather face the devil they know.

I could easily be among the latter. I am one of the incredibly lucky people who, when struck by cancer, had a fantastic health plan. I work at a university with a cancer research and treatment center, so I had access to physicians who were highly expert and used the most up-to-date treatments and resources. My university has a self-insurance plan with 90-10 coverage, a low deductible, and a low out-of-pocket annual cap. (I have thanked my 2005 self over and over for deciding to pay the higher monthly premium for this plan, rather than choosing the cheaper HMO.)

It's easy to imagine that a universal-coverage plan could limit my choice of physicians. Or perhaps it would limit what they could do to treat me--for example, maybe all medical care would be restricted to HMO levels. For someone who's had fewer limitations, like me, that is scary. On the other hand, I don't believe we have to fear such extreme restriction. And even if some restriction occurred, it seems only just for the few of us who now enjoy wildly disproportionate benefits to accept a mild adjustment downward so that our millions of disadvantaged neighbors can finally get some basic care.

And that's where the Slate article is especially reassuring. Looking at all nations with some form of socialized medicine, other than England--which is apparently abysmal for cancer treatment and survival--outcomes are far better there than here. Which tells me that, for all my choice and luck, I could be doing even better yet.

I've started to become one of those girlswho aren'tplaying nice. The pink, the fluff, the incessant marketing machine... It feels a lot like the post-9/11, "Be patriotic! Go shopping!!"

There are some good reasons for a cancer to have a month--better than for large racial categories. Women over 40 should get an annual mammogram, and maybe seeing ads for pink toasters and pink toolbelts at this time of year can help them remember.

I also think there is some legitimate merit to giving people a way to do something about this disease. Getting breast cancer makes you feel helpless. I am certain that watching someone get breast cancer also makes you feel helpless. When I inventory my own personal relationships, I think of my husband, who had to go through 8 months of treatment and all the fear and anxiety, with nothing that he could really do to change my outcome. My parents, my friends... I am also a spooky exemplar of how many women are getting breast cancer, and how little we can do to predict or stop it. I'm a magnet for everyone else's breast cancer experiences, especially guys whose moms get it--I have heard from more than I can count on a hand, in the last year.

I know that people close to me want to change my outcomes, and I know they want me to understand how urgently they care. So what can they do? They can shop, and they can participate in big group activities like runs--the latter are even better, because they require personal pain and sacrifice. (By the way, one of posts referenced above links to a great Onion article, 6000 Runners Fail to Discover Cure for Breast Cancer.) After 9/11, I wanted to give blood, because--literally, and don't laugh too hard at my hokiness--I felt a desire to bleed for the sake of all the other people who had shed blood. A common fate kind of thing.

Yes, there are better things to do. Giving money directly to research and advocacy groups, volunteering at a cancer treatment center or a wellness community, regularly contacting members of Congress to lobby for better cancer funding (and healthcare, maybe?!)...all of these may be more powerful. They're also harder to do, and now that I'm back to my busy life, I know that it's a lot easier to do a few website clicks between meetings than to keep track of bills in the Senate.

[Along these lines, I got the following email a few days ago--it seems to offer the way to do something real, very quickly, and very easily. So of course I was suspicious!

> Please tell ten friends to tell ten today! The Breast Cancer site is> having trouble getting enough people to click on their site daily to> meet their quota of donating at least one free mammogram a day to an> underprivileged woman. It takes less than a minute to go to their site> and click on 'donating a mammogram' for free (pink window in the> middle).>> This doesn't cost you a thing. Their corporate sponsors /advertisers> use the number of daily visits to donate mammogram in exchange for> advertising.>> Here's the web site! Pass it along to people you know.>> http://www.thebreastcancersite.com/

So I searched for this pitch on urban legends sites, and about.com had the following:

Except for the part where it says "The Breast Cancer Site is having trouble getting enough people to click on it daily," this dated email flier (circulating since 2001) remains basically true. In 2002 alone, the highly successful site and its advertisers funded a total of 1,624 free mammograms for underprivileged women, thanks to the daily clicks of visitors. The Breast Cancer Site has been reviewed by health advocacy groups and various media outlets and recommended by sources like Ms. Magazine. It is well worth a daily visit.

That is good news, and not even hard to do.]

Anyway, I started by objecting to the month, and here I've really defended it. It's harder to express my objections, but I'll try. A Month is reductive. The pink onslaught is infantilizing and trivializing. There is a tyranny to breast cancer culture that allows only a narrow range of expressions, emotional responses, and actions. (I'll never forget my first--non-Wellness Community--support group experience, in which new women like me were told not to think things we said, not to feel what we expressed, and more than anything, that praying was the only thing to do. I never went back.) I don't want to be either a pink-wearing blubberer, or a pink-wearing "survivor" in the mold of The Movement. Basically, I guess it's that breast cancer, though widespread, is still a really personal and individual experience--no two women I know have had exactly the same treatment--and I don't like feeling my personal experience forced into the dehumanizing context of the mob.

And finally--an annual reminder to get a mammogram didn't do a damn thing for me. I was too young to be getting mammograms. This week, I was on a conference call with three other fantastic bloggers (their blogs are now linked, at right) who were also all too young for mammograms when they were diagnosed. And I guess that's another reason I dislike The Movement--it's focused so much on women who are older, with different concerns and different worldviews. Perhaps Breast Cancer Awareness Month should be urging younger women to get their breasts groped--by themselves, by others (hello, Noah!), whatever it takes--get some hands on those boobies and check for things that shouldn't be there!

One last note for today. Today is the one-year anniversary of my completion of cancer treatment. I had my last radiation treatment last year, I got my survival certificate from Noah, and I walked out of the center and into my "new reality" as someone cured, post-cancer, and on the way to being healthier than ever.

My oncologist told me it can take a year for some side effects to ease. My hair is still only a few inches long; my feet have only recently stopped having pain and burning from the Taxol; my right armpit and lat are still a little numb from surgery. But overall, I am healthier and in better shape than I've been in years. My life, knock wood, is back "on track"--as a relatively young woman (and junior professor), there is a climb and a progression that characterizes the life path, and I'm no longer sitting on the bench watching other people hike by.

A year past cancer treatment. I gotta say, it still seems like yesterday.

Sunday, September 30, 2007

Got a phone message today saying that my aunt, who has multiple myeloma, is in the hospital. Things have been looking worse for her lately. She's survived almost 13 years so far with this disease, but it's nasty. Much worse than breast cancer (not a "good" one, for sure). I don't have details, but this is her second hospital stay in the last several weeks, and I know her current chemo has been extremely tough. So I'm feeling some concern, and it makes me reflective.

Basically, a new study apparently shows that women who drink alcohol regularly--even as little as a drink a day, and regardless of what kind of alcohol it is--face an average increase in risk of breast cancer of 30%. Now, as a Wired blogger helpfully points out,

Thirty percent is a big deal: Reuters points out that women have, on average, a 1 in 8 lifetime chance of developing breast cancer, so a 30 percent change ups that chance to 1 in 6.

(By the way, don't miss the photo accompanying that article. Someone has quite the gift for appropriate illustration.) Anyhoo, while the risk is substantial, I've been scouring the various articles for more detail on methodology, and I can't find it. So my personal jury is still out on this one (and thank goodness; I needed some quiet inside my head).

The articles that get into a possible mechanism for the finding generally say that alcohol is hypothesized to disrupt hormones, and this leads to the kind of estrogen imbalance that causes breast cancer. Well, my tumor was not fed by estrogen (or progesterone). But none of the articles mention whether the risk was equivalent across tumor types, although the only proposed mechanism is hormonal. That is frustrating.

The study on which my nutrition program is based, for example, showed no major benefit for women who DID have ER-positive tumors, but a big benefit for ER-negatives like me. It's clear from virtually all breast cancer studies that the tumor type is one of the biggest "it depends" factors out there. So it would really be nice if the press had covered this aspect. Even the medical press has not. We'll see what happens when the study gets published; hopefully we'll find out then.

In other news, I am very happy to see this next article. Basically, it tells me that I can forget about needing to buy sexy lingerie or plan romantic weekends: I got breast cancer, and that's a marriage boost in itself. Yay! (Noah's thrilled too!)

And finally, looks like those newsmakers in Barcelona aren't done yet (or, those who weren't invited decided to prove they still matter, too). Anyway, today's LA Times will report that childhood exposure to DDT has been shown to increase later risk of breast cancer by a whopping 400% (though the sample size is admittedly small). Since DDT was outlawed before I was born, it may not have affected me. But it is yet another reminder of how many scary chemicals we swim around in, and how much predestination is involved in whether each of us gets hit by something terrible.

Tuesday, September 25, 2007

Noah sent me this bit from Yahoo! News about survivorship plans, a new trend (like fab shades!) in cancer care. My own oncologist did not give me a written plan, but I am clear on many things:

For the next year (like the last), I'll have checks every 3 months. This includes blood testing, to look for chemical markers of breast cancer recurrence, and physical exams.

Once a year, I have a mammogram. If anything funky is found then or at any other time, I may also have an MRI.

If I were to notice any difficulty breathing or other heart-related symptoms, I expect I would have an echocardiogram, since I had some of the chemo drugs that can cause heart failure. But there is no special monitoring of that because I've seemed heart-healthy.

After the next year, my exams will go to 4- to 6- month intervals for up to the 5-year mark. After that, they may revert to annual checks.

I have my nutrition plan with my nutritional oncologist, ongoing.

I have copies of all my records, including pathology reports and treatment records.

What I don't have is a very specific list of symptoms to watch out for. I have a mixed opinion of that piece of advice. The power of suggestibility surely has to be weighed against the benefits of knowing what to look for. If I knew that a persistent pain in the 3rd rib from center was a warning sign of metastasis, I'd be rubbing that 3rd rib constantly to assess it, and pretty soon it would indeed hurt like hell! So perhaps being in the dark a bit is good for me here.

Overall, though, it seems to me that better knowledge and awareness are being emphasized, and that is terrific. Also, the medical community is awakening to the fact that cancer treatment is emotionally and cognitively overwhelming, and realizing that we'll all have better outcomes if physicians take on just a tiny bit more of the burden of managing information (not just drugs and procedures). Based on the confusion I saw even in intelligent, thoughtful members of my own support group, this will surely help!

Saturday, September 22, 2007

Boy, I gotta say--the information is certainly out there if you want it. Why didn't I pay attention earlier? It's not like this list of good cancer-fighting foods is boring or yucky. It even includes chocolate!

Saturday, August 25, 2007

Before you ask, my back has felt better this week. Lots better. So, so far I am not calling back for an MRI. I'll let you know if that changes.

Now--the LA Times today has a really terrific article about nutrition and cancer. It talks at length about foods purported to lower cancer (or recurrence) risk, and the strengths and flaws in various studies. I'm happy to see many of the recommendations of my nutritional oncologist, Rachel Beller, validated in the article. She really seems to base her approach on solid research and evidence, which of course appeals to me.

Among the key points for me:

In one study, breast cancer survivors who ate 5 servings of fruits/veggies a day and exercised regularly achieved a 44% decrease in the rate of recurrence. That's great! Those who only ate the veggies, OR who only exercised, did not get any benefit.

Cruciferous vegetables (broccoli, kale, brussels sprouts), tomatoes, spinach, apples, and blueberries are among the key foods that have been shown beneficial.

The benefits come from the whole foods themselves, not supplements of just one nutrient or chemical at a time.

So, Rachel has me getting the vast majority of my calories these days from veggies and fish (or tofu), with fruit and yogurt close behind--and the items on the list are definitely staples. And I'm playing volleyball for hours a week, and walking Kibble as well (though less than he'd like). Everything is as organic as possible, so that there aren't toxins and chemicals competing with the positive effects of the food. I'm almost down to my goal weight, which removes that as a risk factor.

It is hopeful and amazing to think that there could be a cell sitting inside me, with the potential of turning into another tumor (or of starting a cascade of cells tumbling in metastatic unison to become something really ugly), but what I'm doing could stop it. It's like Schrodinger's cat: I do one thing, and I get cancer. But I do another thing--perhaps the thing I'm doing by following Rachel's advice--and I live 50 more years cancer-free. That cell just sits there, and thinks about it, and then shrugs and stays healthy.

Anyway, everyone: Lose weight if you need to lose it, eat good things, and move your body! Let's all give the giant middle finger to cancer!

Friday, August 17, 2007

No news is good news, in my case. I have celebrated my summer-after-cancer by travelling to Europe, tending the garden, playing with my dog, and having fun with Noah. I have played hours and hours of volleyball--generally with more energy and skill than before treatment. Basically, I feel great.

Of course, cancer is evil. I could be feeling this great and still have something wrong. Today, I had my latest 3-month check (and it's a year since I ended chemo!!). The physical exam was clear. I haven't yet gotten results of my blood test, but I'm sure I would have heard if they were bad. There's just one little thing: I've had a nagging lower-back pain for about the last month. It could be travel, different beds, volleyball, our own wearing-out bed, or even the way I slump as I sit here in the computer. But once you've had cancer, everything is cancer.

So the oncologist has a "one-month rule": if a pain persists for a month, we take it seriously. We do an MRI and check it out. Well, I'm almost at a month with my back, but it's felt better for a couple of days. Metastases don't get better, so if the pain goes away (or even eases a lot), then it's unlikely to be a metastasis. But if I am still feeling like this in a week, I'm supposed to call back, and we'll be doing an MRI.

I'm not too worried, but it's all relative. I'll be paying attention to my back for the next week, and trying hard not to be a hypochondriac at the same time. A good friend of my sister-in-law's was just diagnosed with metastatic melanoma in his spine. Started as a backache. He had it checked out, and now things are pretty serious for him. So it's easy to freak out a bit.

Otherwise--there have been some interesting cancer stories in the news lately. Many people have asked for my reaction to the news that a high-vegetable diet does not help prevent recurrence. My diet (which I'll post here soon) is not that. It's a basic high-fiber, low-fat diet that tends to have lots of veggies, but only prescribes the standard RDA kind of approach.

(I saw my nutritional oncologist yesterday, too, by the way. I'm back strictly on the plan for a while, to lose a little more weight and be more disciplined after our European culinary free-for-all.)

And I really found this piece, in the NY Times, poignant. Also scary. It's written by a guy (a cancer survivor) visiting an ex-girlfriend and former fellow survivor, now terminal patient. While searching for the link for that, by the way, I also encountered this somewhat treacly story (though, to be fair, I actually agree with it) about finding the positives from a cancer experience.

Friday, May 18, 2007

Today's CNN home page features the headline Cancer Fears Self-Fulfilling, and I was immediately curious. I was wondering whether it would say that people like me, who have had cancer and now have a recurring dread or even terror of its return, might actually hasten bad news through our fears. Of course, the article isn't about that--it discusses how there are so overwhelmingly many things that can give us cancer that many people don't bother to take any preventive steps.

Well, that first, then: Immediately after ending chemo, I addressed my biggest remaining risk factor by losing 30 pounds. I was hoping to lose 36, and haven't yet, but I've kept off the 30 with really no trouble. As for other changes, I've started taking curcumin, after Judy alerted me to a study that showed it prevented later metastasis in mice. I know that the internet story about microwaving plastic is a hoax, but I still avoid microwaving plastic these days--what the heck. And I do try to buy organic and avoid any of those chemicals that I can--but I still breathe the air in Los Angeles. I hope everyone does these kinds of things. And doesn't smoke. And if any of that doesn't describe you, I hope you'll change.

But back to fear. There really is an ongoing fear that comes with this disease. I am so happy now, being healthy and strong and in better shape physically than I have for years. My brain is back, my body is more than back, my scar is fading, I'm going to Europe for a dream vacation, and basically my life is just incredibly precious and wonderful. I can feel the intense enjoyment of just living (even on a sad or irritable day) so much more readily now. There is a kind of insane joy just in seeing my hair get longer.

And that same awareness can make it very frightening to think that I could go to the doctor in July and be told I have metastatic cancer that can't be cured, and have to go back on chemo and get weak and blurry and bald, and know that forward momentum is for other people's lives and not mine. There is often a fairly active fear that the rug will be pulled from under me.

The kind of cancer I had is most risky for the first 2 years. This is constant knowledge. Each check-up is more portentous than the next, which is great when they are "all clear." Even after the 2 years, the declining slope of the risk graph is still pretty high until 5 years, and then it drops way down. So I will still have some time to worry.

And to wonder how to live. This may seem easy, but here's a puzzle for you. You are me. You still want to have kids, and you don't have a lot of time left for that. But the cancer community advises waiting at least 2 years after treatment before you start to try, in case you do get a recurrence and won't be able to be around for your kids. OK, now I'm 41. Then add in my own personal risk profile, which says that I probably have to worry for 5 years post-treatment, and now I'm 44. What do you do? Do you have a kid? How sure do you have to be that you'll live in order to have them? How sure are you that you will?

Saturday, April 28, 2007

During our one-week cram session to learn as much about breast cancer treatment as possible, Noah and I repeatedly saw references to chemo brain. The research was inconclusive, but many women report cognitive deficits--sometimes severe--during chemotherapy. The best study we read about, from the June 2004 issue of the journal Cancer (and mentioned here, about 3/5 of the way down the page), noted that many women reporting cognitive impairments had them before chemotherapy started, so it was unclear whether the cause was the toxins or just the preoccupation and anxiety that come with cancer. The newer research, linked above, is more grave: it appears that brain cells are killed by the chemo, and that the effects can last a very long time.

Of course, for me, this was perhaps the most frightening potential side effect. My identity is pretty tightly structured around intellect--which provides my livelihood, too--and the thought of losing mental acuity... You can imagine.

Like most people's, my oncologist was sympathetic but not especially helpful. "It could happen," was all she could really say, and she pointed us to that 2004 study, which offered hope in its suggestion that it might be emotions, not neurons, causing trouble for many people.

I did have chemo brain. You can ask Noah, who tried to be forbearing but occasionally had to point out that I was impaired. I lost words constantly. I was a bit ditzy and scrambled (good thing I had a platinum blond wig for those moments, so I could really be a stereotype). It was not as horrifying as I'd feared--more like mild aging, maybe, than a brain injury--but it was real, and annoying, and not the way I want to live.

And I'm really happy to report that it went away, very quickly after the end of treatment. I don't think I have any lasting cognitive effects at this point. I've been able to go back to work and put sentences together, both in papers and in front of MBA classes. That has been one of my many reliefs in life A.D.

Thursday, April 12, 2007

I'm happy to say that breast cancer has increasingly become a background (rather than foreground) presence in my life. The rhythm of my days is no longer dictated by treatments and weakness. Sometimes, perhaps, I even leave it too far behind, caught up as I am in the headlong pursuit of tenure and the juggling of daily demands.

In any case, I find myself with less to say regularly about the cancer journey--and I'm glad of that, and hope it stays that way! But that doesn't mean I need to throw over the blog. I think I'll morph it into another common blog form: the compendium. I'm constantly struck by the constant barrage of news coverage related to breast cancer. I figure I'll post links here, and--when something is particularly interesting--even comments.

And never fear, those who prefer the logorrheaic blog, I'll still post when noteworthy things arise!

So, to begin:Bad NewsSo far, John Edwards is my favorite presidential candidate for '08. And although I didn't love getting added to a fundraising list when I wrote a note of support, I've been pleased and impressed by how he and his wife Elizabeth have handled her recurrenceof cancer. It was terrifying to hear about her. Many articles refer to her "particularly deadly" form of cancer, the "triple-negative" (estrogen-negative, progesterone-negative, her-2 neu negative). Well, I'm a triple-negative too, with the highest (worst) possible Bloom-Richardson score. News like this makes me seek refuge in the numbers, and hope I land on their good side: 80% chance I'm free, 20% chance I'm not.

Cute NewsThe LA Times yesterday carried an odd but somewhat heartwarming story about the recovery of 2000 wedding dresses, intended for a breast cancer fundraiser, then stolen, then found at the Mexican border.

Important NewsNot that it's clear at all, but the news/debates on best diagnostic practices is worth attention: good summaries at salon.com.

Tuesday, March 20, 2007

So how did I spend my first anniversary of a cancer diagnosis? In China.

It was a work trip--I accompanied 76 MBA students (with several faculty & staff colleagues, too) to Shanghai, where we spent 5 days meeting with companies from Starbucks to APL shipping and 2 days seeing the sights. Shanghai is like a few New Yorks piled on top of each other: busy, bustling; horrible traffic (less volume than LA, but much more insane); and, from what I hear, more construction cranes than in the rest of the world, combined.

It's a shopper's paradise where you can get North Face jackets for about $18 each, and knock-off Birkin bags for about $40. A one-hour foot massage that was the best of my life was about $3.50. About halfway through, I began feeling really, really guilty about the guys who were sitting there giving the massages. When I pay $3.50, you know he is getting at most half of that (and probably less) for his hour's great work. And Starbucks--which is all over Shanghai--still charges $4 for a latte. China is getting rich on the backs of its poor. The gifts I bought for people are pretty much all handmade, because labor is still cheaper there than machinery. I could hardly stop purchasing, but there's definitely a guilt factor involved. And for all the great service we got everywhere, there's not even a custom of tipping!

Shanghai is not traditional China; we made a brief visit to SuZhou, nearby, and that was much more quaint and old-fashioned. Still, Shanghai has great energy and a breathless feeling of hastening progress. It was exotic and invigorating, and everyone we met was looking forward with a lot of hope. As a place to mark my first year AD, it was perfect.

Tuesday, March 13, 2007

February 26, a year ago.I'm in the shower, shaving an underarm, and my fingers slip in the soap, down just a couple of inches. It feels like I have a knot, like a raised bruise, only it doesn't hurt. I check the other side--no knot. I say aloud: "Shit." Just doesn't seem normal.

Out of the shower, I put lotion on Noah's fingertips, place his left fingers over the knot, his right on the knotless other side. He feels it immediately, nods--but sure, of course, that it's nothing.

February 27, a year ago.I call the faculty clinic. My voice rises, a little shrill, when it looks like I can't get a same-day appointment. But it works out.

Fibroadenoma. That's what Dr. Sapkin says, after finishing the exam. "I'll refer you for a mammogram to be sure. Don't worry if they also do a biopsy--they are abundantly cautious at the breast center."

A year ago today.In previous days, I've had my first mammogram ever. The knot showed up as suspicious, so I've also had an ultrasound and biopsy. Also suspicious, but then I had to wait several long days for the lab results. Now I'm back at the Norris Cancer Center, Noah with me for the first time in the series of appointments (since we've been sure, 'til now, that it was really nothing). We're still waiting to hear "fibroadenoma" confirmed, and we've planned a celebratory lunch afterward.

When the nurse comes in, she's surprised to learn that we are there for the results. I'm asked repeatedly for my family's cancer history. We're shown to an exam room, I'm put in a gown. We wait.

Dr. Silverstein, the surgeon, surges into the room, all breezy confidence. He examines me, leaves the gown down like I might not even notice, draws a boob on the whiteboard. (We quickly realize that he spends his days drawing boobs. Every exam room has some of his boobs on the board.) He leaves to check the labs, and no one has said anything to reassure us, and we look at each other, and I am finally scared.

Then he comes back, still breezy, and announces it just like that. "The bad news is, that thing is cancer." He points with his pen, like a sword. "The good news is, we're gonna cure you." Noah and I lock eyes across the room, jaws hanging, faces pallid.

Talking follows, lots of it, the 40-minute crash course in breast cancer, the first dozen decisions made in fog and haste. We meet my oncologist, talk about surgery in 2 days. After an hour in the maelstrom, the medical staff all leave, and we're alone in the exam room, with pictures of boobs--front, side, whole circles, circles with pie-shaped wedges removed, circles with a dark blotch of tumor on the right-hand side--looking back at us.

Wednesday, January 31, 2007

Yes, folks, I'm still here. I've been getting back to my life in a big way--which means work, work, work, writing, writing, writing. (Papers, not blog entries.) Sorry for the silence. The biggest reason is that I have to write an update on The Scare last month, and I just haven't been ready to do it. Soon, though.

Meanwhile--yesterday I had my second 3-month check (yay! I've been out of chemo for 6 months now!) and all was clear. Very good news, of course! I've lost another couple of pounds and am back to most of my physical activity and am really feeling great.

Of course, then, today all over the news is the sad notice that Molly Ivins has died of breast cancer. Dammit, that sucks. First of all, she was amazing and one of my heroes, even though I've apparently been pronouncing her name wrong all these years. Second, breast cancer. Gah. Just when I can start to think of it as innocuous again for a few minutes, it whacks someone fantastic way before her time. Stupid disease.

Your Breast Cancer Blogger Today is...

I have two blogs--an inactive blog on my year of dealing with breast cancer (thankfully, and knock wood!, in the past) and one that has become my current record of adapting to life in Australia and learning to grow/create/cook my own Mexican food in a land with very few Mexicans!